The low FODMAP diet is a process used to find what foods are causing IBS symptoms. The process starts with a diet which is low in FODMAPs (fermentable carbohydrates). It is then followed by a structured reintroduction period to pin-point and diagnose food intolerances.
In this article, I will be discussing the top 10 mistakes that I see people making during this process. Please read each point, as it is unlikely that you will get symptom relief if you are not considering these issues.
Table of Contents
1.Not Getting An Accurate Diagnosis
You may be worrying that your symptoms are due to a condition which is much more serious than IBS.
But, because IBS is a common condition, you probably presume your symptoms are IBS related. You even tell yourself “it’s probably nothing.”
Did you know that your symptoms could also be coeliac disease, IBD, functional constipation / diarrhoea or even bowel cancer? So, instead of guessing about these things, please ensure you get tested by your doctor first.
You will then need to see a specialist dietitian to refine your IBS diagnosis. In some cases you may have a condition which is not IBS such as a food allergy or BAM. Your dietitian will assess you for this.
DO NOT start the low FODMAP diet before getting an IBS diagnosis, as you will be following a diet low in gluten. This means that the doctor will be unable to test you for coeliac disease.
2.Not Eating Enough Fibre
Are you suffering with constipation or incomplete evacuation? May be you are left wondering ”why does this diet make my symptoms worse, yet it helps everyone else.”
Many people complain that the low FODMAP diet causes constipation. But, actually, their diet is just too low in fibre.
It is easy to eliminate a lot of fibre when switching to a low FODMAP diet. So just make sure that for every wholemeal food or fruit / vegetable that you take out, you replace it with a low FODMAP version.
3. Not Considering Movement
The low FODMAP diet is promoted as this amazing IBS ‘wonder cure’ so you may have forgotten that IBS is multifactorial?
This means that diet is only 1 element of IBS. Have you, by any chance, focused all your attention on the low FODMAP diet and are now left wondering “why are my IBS symptoms still so out of control?”
How much are you really moving? Even if you go to the gym 3-4 time a week, ideally you still need that 30 minutes walking on your rest days to ensure your gut is well cared for.
4. Overlooking Mental Wellbeing
Did you forget about the gut-brain axis?
Often, I find that when my take control members start to become frustrated as to why they are not getting symptom relief, it is because they are stressed out as hell.
Stress not only causes IBS in the first place, it also leads to IBS.
I would recommend that you take on board daily mental wellbeing exercises to control this affect.
5. Irregular Eating
Yes, you may feel less bloated when you skip a meal or fast. But, did you know that irregular eating is directly linked to the worsening of IBS symptoms?
You may even be thinking “but when I eat, my symptoms flare up!”
Yes, they will do until you find your triggers and avoid them. But the only reason you are getting temporary symptom relief is because you are not digesting anything at all. This is not a long-term solution to a condition which is literally ruining your life.
6. Not Reading Food Labels
One of the Worksheets I have added in to my Take Control membership teaches members how to read food labels.
This reason why I have added this specifically is that it isn’t quite as easy as you may think…
Have you ever bought food from the ‘free from’ section and been left wondering “why did this cause me a flare up!?”
FODMAPs are not allergens, so they are not in bold on the label or plastered across the front of a package. Heck, some aren’t even individually labelled in the ingredients – ever seen the word ‘flavourings?’
7. Using Inaccurate Information
Have you ever noticed that there are variations in what is classed as low FODMAP between different apps and sites?
Some information out there is out of date or has been taken from studies by those who do not understand the science.
The low FODMAP diet is complicated and it is recommended that you see a registered dietitian. This will ensure accurate information and avoid nutritional deficiencies.
8. Not Finding Alternative Foods
If you are doing the low FODMAP diet alone, you may be thinking “well, what can I bloody eat?!”
Now, I find that individuals get really quite anxious at the prospect of having to follow such a restrictive diet for 4 weeks. I also speak to a lot of people who tell me that they have tried the diet before, but could not stick to it.
Another worksheet that I get Take Control members to do is to look at low FODMAP alternatives for every food they usually eat which is high FODMAP.
Guess what? This allows them to have a varied and enjoyable diet. Which ultimately means they get that long-term symptom relief that is needed.
9. Not Weighing Out Portion Sizes
Ever wondered why a food which causes no symptoms one day, may cause symptoms on another?
Some foods, like sweet potato, contain moderate amounts of FODMAPs in them. This means you can have a certain portion size, but go over that and you will end up with symptoms.
10. Being 100% Gluten and Milk Free
Before you buy the entire ‘free from’ section, please take note of what I am about to say.
Gluten is protein found in wheat, barley and rye. Those with coeliac disease must avoid gluten, but if you do not have coeliac disease, then you do not need to.
The confusion comes as wheat contains a FODMAP carbohydrate called fructan – this is what you are avoiding. So those gluten free oats? Save your money and get the regular ones!
As for milk, I find that some people struggle to adapt to the taste of plant based milks. They tell me that they have just ”cut out all dairy.”
Please do not do this! Again, you are just avoiding the lactose (FODMAP sugar) and not the other bits of milk. So things like lactose free milk and hard cheeses are fine.
Kirsten Jackson is a UK registered Consultant Gastroenterology Dietitian and founder of The Food Treatment Clinic. She has undergone many qualifications to get where she is today, including a UK BSc Honours Degree in Dietetics and Post-Graduate Certificate in Advanced Dietetics. In addition to this, she has FODMAP Training from Kings College London University. Kirsten set up The Food Treatment Clinic in 2015 after first experiencing digestive problems herself. She felt that the NHS was unable to provide the support individuals needed and went on to specialise in this area before opening a bespoke IBS service. Kirsten also participates in charity work as an Expert Advisor for the IBS Network. In addition, she can be seen in publications such as Cosmopolitan and The Telegraph discussing IBS as an Official Media Spokesperson to the IBS Network.